Baylor University Medical Center Proceedings January 2014, Volume 27, Number 1 | Page 65

Looking back and looking forward: The white coat lecture
Donald M. Knowlan, MD

Editor’s note: Dr. Knowlan delivered the Edmund D. Pellegrino, MD, white
coat lecture on August 9, 2013, at Georgetown University School of Medicine
for the class of 2017. I attended to support my granddaughter, Carey
Camille Roberts, an incoming medical student, and asked Dr. Knowlan, an
old friend, if we could publish his lecture in Proceedings. –WCR

ood evening, Dr. Federoff, Dr. Mitchell, class of 2017,
members of the Magis Society, fellow faculty, family,
and friends. What a happy occasion! We are gathered
here in historic Gaston Hall to welcome the class of
2017 to Georgetown University, its school of medicine, its Jesuit
tradition—to celebrate their public entry into the profession of
medicine—and in speaking to you, I hope to honor our beloved
Dr. Edmund Pellegrino.
Two years ago, as I finished teaching rounds at the hospital,
one of our junior students asked if I would deliver a message
to the incoming freshman: “Please tell them it’s worth it!” She
beamed 3 months ago as she crossed the stage and accepted her
medical degree. Her smile said it all: “It’s worth it!”
Today I will speak to you of three things: my class, your
class, and your most important teacher, the patient.
My class entered medical school in 1950, over 60 years ago.
The demographics were a bit different. We were all male and
were older; we had grown up in the Great Depression, and more
than half had served in the military in World War II, fighting
in Europe or the Pacific. All of us would serve in the military
in time. Times were different, simpler I guess. The country was
united, even optimistic. It was a society of duty, self-restraint,
and devotion to country.
As a freshman, it was anatomy lab from 1:00 to 5:00 every afternoon from Labor Day to Memorial Day. You could
always tell a freshman: they smelled of formaldehyde! In
pharmacology, we were promised you only needed to know
10 drugs. We discovered every drug had 10 names and by the
time we were comfortable with one, it became obsolete! In
bacteriology, they taught every detail of diseases that disappeared shortly after we began practice: polio, enteric fever,
rheumatic fever. We learned nothing of genetics. Most of
us served 2 years in rotating internships in dilapidated city
hospitals built in the 19th century, working every other night

G

Proc (Bayl Univ Med Cent) 2014;27(1):63–65

Figure. Donald Knowlan, MD, presenting the white coat lecture in August 2013.
Photo: Georgetown University School of Medicine.

under limited supervision, and then two thirds of us entered
primary care, moving into small communities developed in
the post-war era.
The science of medicine exploded after World War II,
with new specialties, new treatment, and even new diseases.
The prototype new disease appeared in the early 1980s. First,
a 21-year-old man thought to have a viral pneumonia was
discovered to have pneumocystis. Then, a young man with
purple lesions on his legs was thought to have a hematological disorder and was discovered to have Kaposi’s sarcoma. A
patient w